Background: Disparities in screening mammography use persist among low-income women, even those who are insured, despite the proven mortality benefit. We evaluated the prevalence of breast cancer screening non-adherence among hospitalized women and their receptivity to inpatient screening mammography as a novel approach to increase breast cancer screening rate. Methods: A cross sectional study was [...]

Background: Heart failure is a common condition characterized by recurrent exacerbations. Medication and dietary nonadherence are associated with readmissions. Telling smokers their lung age significantly improves the likelihood of successful smoking cessation.  We hypothesized that using hand-carried ultrasound (HCU) to share with patients their own images of inferior vena cava (IVC) measurements would serve as [...]

Background: To evaluate prevalence of non-adherence to breast cancer screening guidelines after bedside educational intervention and informed individualized risk assessment score during an inpatient stay. Methods: A prospective intervention study was conducted among 507 cancer-free (except skin cancer) women aged 50-75 years hospitalized to a general medicine service. Study intervention included one-on-one bedside education via [...]

Background: Adverse drug events (ADEs) are common during transitions from the hospital to the ambulatory setting, with approximately 20% of patients experiencing an ADE within 30 days of discharge. ADEs are often due to patient misunderstanding of the prescribed medication regimen or non-adherence to the regimen.  New approaches are needed to address this problem. Purpose: [...]

Background: Cost-related medication non-adherence (CRN) is a persistent and serious challenge among the elderly population in the US. For elderly patients with limited economic means at increased risk of hospitalization, CRN may elevate the risk of repeated hospitalizations and emergency department visits, and lead patients into a downward spiral of worse heath and higher non-adherence. [...]

Background: Despite the consistently proven benefits of cardioprotective medications, medication adherence (MA) remains a challenge in coronary artery disease (CAD) patients. Studies suggest that up to 50% of patients with CAD are nonadherent to medications, with patient knowledge, beliefs, and expectations playing a vital role. We aimed to assess patient-related medication non-adherence (MNA) factors in [...]

Background: Preventable hospital readmissions are a common problem for medical centers in the United States. Recent studies have focused on what patients perceive as causes for their return to the hospital. One factor driving readmissions is patients’ difficulty anticipating what to expect after they leave the hospital despite discharge instructions, especially anticipating and surmounting challenges [...]

Background: Strategies to reverse the effect of warfarin, a vitamin K antagonist (VKA), may be necessary for patients who are actively bleeding, asymptomatic with markedly elevated INR values, or requiring urgent invasive procedures. The purpose of this quality improvement activity (QIA) was to evaluate adherence to the 2012 CHEST guidelines for use of vitamin K [...]

Background: Sepsis is a leading cause of morbidity and mortality in the US. Annually, over 250,000 people die from sepsis nationwide. Therefore, in 2013 New York State mandated that hospitals adhere to standardized protocols designed to improve sepsis outcomes. A recent cohort analysis on the rollout of these standards demonstrated that mortality decreased by 6% [...]

Background: Up to 45% of Americans do not fill prescriptions because of cost. Medication non-adherence annually leads to $100-$300B in excess morbidity and mortality. To better inform medication cost effects on a potentially vulnerable patient population, our primary aim was to measure annual patient out-of-pocket outpatient medication cost for patients without prescription drug insurance coverage [...]